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. 1999 Sep;34(3):754-9.
doi: 10.1016/s0735-1097(99)00269-7.

Delayed systolic blood pressure recovery after graded exercise: an independent correlate of angiographic coronary disease

S A McHam  1 , T H Marwick, F J Pashkow, M S Lauer
Affiliations
Free article

Delayed systolic blood pressure recovery after graded exercise: an independent correlate of angiographic coronary disease

S A McHam et al. J Am Coll Cardiol. 1999 Sep.
Free article

Abstract

Objective: This study was performed to determine whether a delayed decline in systolic blood pressure (SBP) after graded exercise is an independent correlate of angiographic coronary disease.

Background: The predictive importance of the rate of SBP decline after exercise relative to blood pressure changes during exercise has not been well explored.

Methods: Among adults who underwent symptom-limited exercise treadmill testing and who underwent coronary angiography within 90 days, a delayed decline in SBP during recovery was defined as a ratio of SBPs at 3 min of recovery to SBP at 1 min of recovery >1.0. Severe angiographic coronary artery disease was defined as left main disease, three-vessel disease or two-vessel disease with involvement of the proximal left anterior descending artery.

Results: There were 493 subjects eligible for analyses (age 59 +/- 11 years, 78% male). Severe angiographic coronary disease was noted in 102 (21%). There were associations noted between a delayed decline in SBP during recovery and severe angiographic coronary disease (34% vs. 17%, odds ratio [OR] 2.59, confidence interval [CI] 1.58 to 4.25, p = 0.001). In multivariate logistic regression analyses adjusting for SBP changes during exercise and other potential confounders, a delayed decline in SBP during recovery remained predictive of severe angiographic coronary disease (adjusted OR 2.22, 95% CI 1.27 to 3.87, p = 0.005).

Conclusions: A delayed decline in SBP during recovery is associated with a greater likelihood of severe angiographic coronary disease even after accounting for the change in SBP during exercise.

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